According to information presented in Court, the Denglers owned and operated Elite Lab Services, a clinical diagnostic laboratory based in Tyler. As a Medicare provider, the company would bill Medicare for laboratory services provided to nursing homes located throughout east Texas, including the mileage associated with providing those services. Beginning in April 2014, Gerard and Suzanne Dengler conspired to fraudulently increase route mileage that Elite Lab used to calculate the travel allowances billed to Medicare. From April through October 2014, the company then sought reimbursement from Medicare for mileage that included the falsely inflated amounts.

Under federal statutes, the Denglers each face up to 10 years in federal prison at sentencing and have already agreed to pay restitution in excess of $160,000, which represents the loss to Medicare. The maximum statutory sentence prescribed by Congress is provided here for information purposes, as the sentencing will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the U.S. Probation Office.

The criminal investigation arose from a civil qui tam action filed by former Elite Lab employee Karen Malcolm. In her complaint, Malcolm alleged, among other things, that Elite Lab and the Denglers submitted false claims to Medicare from approximately 2010 through 2014. The United States intervened in the action for purposes of settlement. The Denglers and Elite Lab agreed to pay the United States $3.75 million to settle the lawsuit. As a result of the settlement, Elite Lab will be excluded from participating in Medicare for eight years; Gerard Dengler will be excluded for 10 years; and Suzanne Dengler will be excluded for eight years. The settlement also resolved a separate civil lawsuit in which the United States sought to forfeit funds and property obtained by the Denglers and Elite Lab through their fraudulent conduct.

This matter was investigated by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services – Office of the Inspector General, the Texas Office of the Attorney General – Medicaid Fraud Control Unit, and the United States Attorney’s Office for the Eastern District of Texas. The criminal case was prosecuted by Assistant U.S. Attorneys Frank Coan and Nathaniel Kummerfeld and Special Assistant U.S. Attorney Ken McGurk. The civil settlement was negotiated by Assistant U.S. Attorney Josh Russ. The civil forfeiture action was prosecuted by Assistant U.S. Attorney Bob Wells.

This case was investigated by the U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG), the Texas Office of the Attorney General – Medicaid Fraud Control Unit (OAG-MFCU), and the Federal Bureau of Investigation (FBI). This case is being prosecuted by Special Assistant U.S. Attorney Kenneth C. McGurk and Assistant U.S. Attorney Nathaniel C. Kummerfeld.

Any individuals with knowledge of these or other health care fraud violations are encouraged to contact the Department of Health and Human Services’ fraud hotline at 1-800-HHS-TIPS (447-8477).